Regarding the classification and subtypes of psoriasis, all of the following statements are correct EXCEPT:

Explanation

## Psoriasis Subtypes: Classification and Clinical Features **Key Point:** Psoriasis has multiple clinical subtypes, each with distinct presentations, triggers, and prognostic implications. Erythrodermic psoriasis is rare, not common. ### Correct Statements (Options 0, 1, 2) | Subtype | Presentation | Key Features | Trigger/Prognosis | |---------|--------------|--------------|-------------------| | **Guttate** | Small (1–10 mm) papules and plaques | Sudden onset; trunk and proximal limbs | Post-streptococcal (GABHS); often self-limited; may progress to plaque type | | **Inverse** | Intertriginous areas (axillae, groin, inframammary) | Well-demarcated erythema; **minimal or absent scale** (due to moisture/friction) | Flexural distribution; often overlooked; difficult to treat | | **Pustular (Generalized)** | Widespread erythema with sterile pustules | Systemic symptoms: fever, malaise, arthralgias | **Medical emergency**; high mortality if untreated; triggered by infection, drugs (β-blockers, lithium), or pregnancy | **High-Yield:** Guttate and pustular psoriasis are high-yield subtypes frequently tested in NEET PG. Recognize triggers and complications. ### Why Erythrodermic Psoriasis Is NOT the Most Common **Clinical Pearl:** Erythrodermic psoriasis accounts for **<3% of all psoriasis cases**, not >80%. It is a rare and severe subtype characterized by: - Erythema involving >90% of body surface area (BSA) - Loss of normal skin markings - Systemic symptoms: fever, chills, malaise - Fluid and electrolyte loss - **Medical emergency** requiring hospitalization **Plaque psoriasis** is the most common form, accounting for **~90% of cases**. **Warning:** Do not confuse prevalence: - **Plaque psoriasis** = 90% (most common) - **Guttate psoriasis** = 2–3% - **Pustular psoriasis** = 1–3% - **Erythrodermic psoriasis** = <1–3% (rare) ### Mnemonic: **GIPE** for Psoriasis Subtypes - **G**uttate (post-streptococcal, small lesions) - **I**nverse (intertriginous, minimal scale) - **P**ustular (emergency, systemic symptoms) - **E**rythrodermic (rare, >90% BSA involvement) ### Complications of Severe Subtypes **Pustular & Erythrodermic Psoriasis:** 1. Fluid and electrolyte imbalance 2. Thermoregulation failure 3. Secondary infection 4. Sepsis 5. Death (if untreated) Both require systemic therapy (retinoids, biologics, cyclosporine) and often hospitalization.